Topography Fitting – Start with a trial lens that is close to the
measurement at the

temporal 4-5 mm position.

Manual Keratometer Fitting – Use the median K-reading and start with the
first trial lens with a base curve nearest .3 mm flatter than the median
K-reading.

* i.e. 45.00 D. or 7.50 mm. .3mm flatter is 7.80 B.C. so start with a lens from the trial set closest to 7.80 mm.

DESIRED FLUORESCEIN PATTERN

The best fit will exhibit a light feather touch of the
apex of the steepened area.

The edge profile should show about .2 mm of clearance.Overall lens movement will be 1/2 - 1 mm.The ultimate fluorescein pattern will be as alignment looking as
possible.

DIAMETER SELECTION

The standard Dyna
Intra-Limbal(DIL) lens is 11.2 mm with 9.4 mm BOZ.The lens is
designed to fit intra-limbal and to achieve 1/2 -.1 mm of movement. With adequate edge lift, limbal involvement is acceptable. The overall diameter needs to be at least .2 mm smaller
than the cornea and may need to be smaller or larger than the standard 11.2 mm to meet these criteria. BOZ can be smaller or larger than 9.4 mm as needed for the fit.

EDGE PROFILE

The desired edge lift will
show .2 mm of clearance.The
DIL system starts with a standard edge lift.Flatter or steeper edge lifts are available in a step system.You can order any edge profile in step 1, step 2, step 3 as needed.This is for flatter or steeper edge lifts.All of these changes are computer modeled so that reproducibility is
insured.

Examples - Should the
standard edge profile show pinch off.Start
with a step 1 flat edge profile. This should be adequate in most cases.If the edge pinch off is still present with a step 1 flat profile,
order a step 2 flat profile lens. Increase edge profile as needed to achieve
desired .2 mm of edge clearance.

Inferior pooling is common in many irregular corneal designs as the lenses stand off at the 6 o'clock position. This is overcome by ordering our Flat/Steep Option that has steeper PC's in one quadrant, but standard PC's at 3, 12, and 9 o'clock positions.

Some keratoconus
types do not respond well to specialty cone designs, like the Dyna Cone
design, which have smaller optical zones.Globus cones, double cones or superior cones need larger optical
zones to accommodate these unique shapes.The DILlens works where other designs fail because it has a large optical
zone (9.4 mm) and covers the large area of corneal irregularity.

STARTING TRIAL LENS:

Manual Keratometer Fitting - Use the median K-reading and start with the first trial lens with a base curve nearest .3 mm flatter than the median K-reading. * i.e.45.00 D or 7.50 mm. .3 mm flatter is 7.80 B.C. so start with a lens from the trial set closest to 7.80 mm.

DESIRED FLUORESCEIN PATTERN

The best fit will exhibit a light feather touch of the
apex of the steepened area. The edge profile should show about .2 mm of clearance.Overall lens movement will be .1/2 - 1 mm.The ultimate fluorescein pattern will be as alignment looking as
possible.

DIAMETER SELECTION

The standard Dyna
Intra-Limbal(DIL) lens is 11.2 mm with 9.4 mm BOZ.The lens is
designed to fit intra-limbal and to achieve 1/2 -.1 mm of movement. With adequate edge lift, limbal involvement is acceptable. The overall diameter needs to be at least .2 mm smaller
than the cornea and may need to be smaller or larger than the standard 11.2 mm to meet these criteria. BOZ can be smaller or larger than 9.4 mm as needed for the fit.

EDGE PROFILE

The desired edge lift will show .2 mm of clearance. The
DIL
peripheral system starts with a standard edge lift. Flatter or steeper edge lift are available in a step system. You can order any edge profile in step 1, step 2, step 3 as needed.This is for flatter or steeper edge lifts.All of these changes are computer modeled so that reproducibility is
insured.

Examples - Should the
standard edge profile show pinch off,start
with a step 1 flat edge profile.This
should be adequate in most cases. If edge pinch off is still present with a step 1 flat profile, order a step 2 flat profile lens. Increase edge profile as needed to achieve desired .2 mm of edge clearance.

Many keratoplasty patients need visual enhancement following surgery.A critical component of these fits is to vault the host-graft
interface area.Impingement of
this area will result in corneal deteriorate and/or graft failure.A larger lens with a larger optical zone is therefore needed to
accomplish this. The DIL
lens meets this criteria. Reverse geometry can be incorporated into the DIL lens design.

KERATOPLASTY TYPES:

STANDARD GRAFT - Donor zones of 6-9 mm. with no
steepening in the graft zone.

STEEP GRAFTS - When steepening in the donor area occurs.

TILTED GRAFTS - Some grafts present with a steepened area on the host at the donor, host junction.

SUNKEN GRAFTS - In this instance the donor area sinks down and the topography resembles a post refractive surgery cornea. Reverse geometry is frequently needed.

STARTING TRIAL LENS:

Topography Fitting – Start with a trial lens that is
close to the measurement at the

temporal 4-5 mm position.

DESIRED FLUORESCEIN PATTERN

The lens should show a minimum vault over the donor
cornea and good alignment with host cornea. In the case of a steepened
graft, a feather touch at the apex of the steepened area is desirable.

DIAMETER SELECTION

The standard DIL
lens is 11.2 mm.The lens is
designed to fit intra-limbal and to achieve 1/2 - 1 mm of movement. With adequate edge lift, limbal involvement is acceptable.The
overall diameter need to be at least .2 mm smaller than the cornea and may need to be smaller or larger than the standard 11.2 mm to meet these criteria.

EDGE PROFILE

The desired edge profile will show .2 mm of clearance. The
Dyna Intra-Limbal system
peripheral system starts with a standard edge lift. You can order any edge profile in step 1, step 2, step 3 as needed.
This is for flatter or steeper edge lifts.All of these changes are computer modeled so that reproducibility is
insured.

Examples – Should
the standard edge profile show pinch off.Start with a step 1 flat edge profile.This should be adequate in most cases.If the edge pinch off is still present with a step 1 flat profile,
order a step 2 flat profile lens. Increase edge profile as needed to achieve
desired .2 mm of edge clearance.

The best fit will
exhibit a minimum vault to a light feather touch on the central cornea. The
edge profile should show about .2 mm of clearance. Overall lens movement
will be 1/2 - 1 mm. The ultimate fluorescein pattern will be as alignment
looking as possible.

DIAMETER SELECTION

The standard DIL
lens is 11.2 mm.The lens is
designed to fit intra-limbal and to achieve 1/2 - 1 mm of movement. With adequate edge lift, limbal involvement is acceptable.The
overall diameter need to be at least .2 mm smaller than the cornea and may need to be smaller or larger than the standard 11.2 mm to meet these criteria.

EDGE PROFILE

The desired edge profile will show .2 mm of clearance. The
Dyna Intra-Limbal system
peripheral system starts with a standard edge lift. You can order any edge profile in step 1, step 2, step 3 as needed.
This is for flatter or steeper edge lifts.All of these changes are computer modeled so that reproducibility is
insured.

Example - Should the standard edge profile show pinch
off. Start with step 1 flat edge profile. This should be adequate in most
cases. If the edge pinch off is still present with a step 1 flat profile,
order step 2 profile lens. Increase the edge profile as needed to achieve
desired .2 mm of edge clearance.

These patients present with corneas that are flatten
centrally in a 6-8 mm zone.It
is best to think of this fitting challenge as fitting two distinct areas –
the flatter ablated zone and the original host cornea.

STARTING TRIAL LENS:

Topography Fitting:Take the central Ks and a reading at the 4 mm temporal area.

Manual Keratometer Fitting: Take central Ks and then
get temporal measurements or use pre-surgery K readings.

The base curve of the Dyna
Intra-Limbal lens will be 1
diopter steeper than the flat central K.To determine the amount of reverse curve needed, calculate the
difference between the base curve and the 4 mm temporal measure. * i.e.
central Ks of 40.00/42.00 and 4 mm temporal K of 44.00.Select a trial lens of 41.00 with 3 diopters or the Series B
lens.

Try a Series B Special
Reverse Geometry Series that has a 3 D. reverse
curve.

DESIRED FLUORESCEIN PATTERN

An alignment pattern is the ultimate goal, but that is
difficult to achieve.Get as
close to an alignment pattern as possible.You want to see minimal vaulting in the central region.The lens with an 11.2 mm diameter, will move only 1/2 - 1 mm and
should not impinge the limbus. The lens is made from Menicon Z material for
good oxygen transmission and good wetting so metabolic wastes are washed
away.

In our example if the mid-peripheral area is pinched
off, you need less reverse curve so go to a Series A.If the mid-peripheral area is showing pooling you need more
reverse curve so go to the Series C.

Select the 11.2 mm diameter unless you have a small
cornea or a very large cornea. Lenses are available from 10.0 to 11.6 mm.All other parameters are totally custom and all parameters are available.

EDGE PROFILE

No one peripheral system will work on all corneas.You can get the edge profile in standard or any degree of flatter or
steeper. * i.e. one step flatter, two steps flatter, etc.

DO NOT fit the edge too tight.You MUST have adequate tear exchange under the lens.

Menicon Z is the first RGP contact lens to
receive FDA approval or up to 30 days continuous wear. The breakthrough hyper Dk/t material surpasses the competition. Menicon Z is the only RGP offering extraordinary levels of oxygen transmissibility and excellent physical properties.